The lead nurse reviews the staffing schedule and acuity reports for the unit. Which client variable does the nurse need to consider when approving staffing requirements?

Family situation and needs.

Client demographics.

Family health literacy levels.

Client learning preferences.

Answer and Explanation

The Correct Answer is B

A. While important for overall care planning and discharge support, these factors do not directly affect nursing workload or staffing levels on the unit. A client may have a very supportive family, which can reduce the time needed for teaching or emotional support, but this does not change the frequency of assessments, medication administration, or monitoring required, which are the primary drivers of staffing decisions.

B. This is the most critical factor for determining staffing needs. Demographics include age, medical diagnoses, comorbidities, and acuity level, all of which directly influence the complexity and intensity of nursing care. Older adults, clients with multiple comorbidities, or those with high-acuity conditions such as post-surgical status or unstable vital signs require closer monitoring, more frequent interventions, and greater nursing attention. Acuity reports categorize clients based on these characteristics, helping the lead nurse assign staff safely and appropriately to ensure optimal patient outcomes and prevent nurse burnout.

C. Health literacy is important for patient education and discharge planning but does not significantly impact the number of nurses required for direct care or monitoring during a shift.

D. Understanding how a client learns best is useful for tailoring teaching strategies, but it does not influence staffing requirements. Adjustments for learning preferences can usually be incorporated into regular care without altering nurse-to-patient ratios.

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Correct Answer is C

Explanation

A. Assessing for gastric pain is important, especially when a client switches to NSAIDs like ibuprofen, which can cause gastrointestinal irritation or bleeding. However, this assessment is secondary and depends on understanding why the medication was being taken.

B. Knowing the dosage of ibuprofen is critical to ensure safe administration and prevent adverse effects such as renal impairment or GI bleeding. Yet, the nurse first needs context about the purpose of the medication to interpret dosage relevance.

C. This is the most important initial information. Understanding the reason for taking aspirin—whether for cardiovascular protection, pain, or anti-inflammatory purposes—guides immediate clinical decisions, including whether ibuprofen is an appropriate substitute. For example, if aspirin was prescribed for cardioprotection, substituting with ibuprofen could increase cardiovascular risk. Therefore, obtaining this information first ensures safe and appropriate care.

D. Amount of pain control is relevant if the aspirin was being used for analgesia. However, without knowing why the aspirin was prescribed, evaluating pain control may lead to unsafe assumptions regarding the appropriateness of ibuprofen.

A. Discuss necessary fluid restrictions as well as food restrictions. B. Review teaching about the effects of foods rich in Vitamin K. C. Explain that no dietary restrictions are needed with warfarin. D. Provide a written list of additional foods high in potassium.

Correct Answer is B

Explanation

A. Fluid restrictions are not routinely required for clients taking warfarin unless there is another condition (e.g., heart failure or renal disease) that necessitates it. This option does not address the client’s misunderstanding and introduces unrelated information, making it inappropriate.

B. This is the correct response. Warfarin works by inhibiting Vitamin K–dependent clotting factors. Therefore, foods high in Vitamin K (such as green leafy vegetables like spinach, kale, and broccoli) can reduce the effectiveness of warfarin by promoting clotting. The client has confused potassium with Vitamin K, which is a common misunderstanding. The nurse should correct this by reviewing dietary considerations related to Vitamin K intake, emphasizing consistency rather than complete avoidance to maintain therapeutic anticoagulation.

C. This statement is incorrect. While clients do not need to completely avoid foods with Vitamin K, dietary intake must be consistent to prevent fluctuations in warfarin effectiveness and INR levels. Saying there are no dietary considerations ignores an important aspect of safe medication management.

D. Providing a list of potassium-rich foods reinforces the client’s misunderstanding. Potassium intake is not the primary concern with warfarin therapy. This option fails to correct the error and may lead to improper dietary restrictions.

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The lead nurse reviews the staffing schedule and acuity reports for the unit. Which client variable does the nurse need to consider when approving staffing requirements?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who reports running out of aspirin 1 week ago and taking ibuprofen as a replacement. Which information should the nurse obtain from the client first?

Correct Answer is C

Explanation

Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

Correct Answer is B

Explanation

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